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Home My WebLink About09-21-07 ....:..J 15056041147 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes ~ PO BOX.280601 ~ Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 0009 Date of Birth 161344399 12222006 06071943 Decedent's Last Name Suffix Decedent's First Name MI EBERSOLE WILFORD D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Ix: 1. Original Return L_ 2. Supplemental Return 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required XI J 6. Decedent Died Testate (Attach Copy of Will) 7 Decedent Maintained a Livin9 Trust , (Attach Copy of Trust) 1 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ] 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number DIANE G RADCLIFF, ESQUIRE 7177370100 Firm Name (If Applicable) _l REGISTERO!= WILLS ~u'~E ONLY First line of address ., . 3448 TRINDLE ROAD Second line of address 1,-- ) City or Post Office [', ) DATE FILED r',,) CAMP HILL State PA ZIP Code 17011 Correspondent's e-mail address: Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S~,N,.A)TUREOFPERSON______RESPONSIBLEFORFILlN~ETURN DATE ~ _ DonnaJDeaven 1-J~"'D7 ADDRESS 17055 Diane G Radcliff, Esquire Hill, PA 17011 Side 1 L 15056041147 15056041147 ....:..J ~ 15[]5b[]42148 REV-1500 EX Decedent's Name Wilford 0 Ebersole RECAPITULATION 1. Real Estate (Schedule A).......................................................................................... 1. 2. Stocks and Bonds (Schedule B)............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D).......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................ 5. 6. Jointly Owned Property (Schedule F) [J Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous NCln-Probate Property (Schedule G) 'X' Separate Billing Requested............. 7. 8. Total Gross Assets (total Lines 1-7)....................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 11. Total Deductions (total Lines 9 & 10)......................................................................11. 12. Net Value of Estate (Line 8 minus Line 11).............................................................12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J)................................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13)................................................. 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X .00 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 0.00 16. 0.00 17. 0.00 18. 19. Tax Due.... .... ....... ....... ........ ........ ........... ...... ...... ...... ........ ......1-9. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L Side 2 15[]5b[]42148 Decedent's Social Security Number 161344399 670.46 8,022.77 20,966.08 0.00 29,659.31 17,060.10 15,556.58 32,616.68 -2,957.37 -2,957.37 0.00 0.00 0.00 0.00 0.00 D 15[]5b[]42148 -.J ~EV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Wilford D Ebersole --- -------.. ----- STREET ADDRESS 4717-A Charles Road File Number 21-07-0009 CITY Mechanicsburg --lSTATE-- I PA [ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 TotallnteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) 0.00 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.................................................................................[' IJCj b. retain the right to designate who shall use the property transferred or its income;.................................... r_JC: c. retain a reversionary interest; or... ...... ............................ ................... ...... ...... .............. ...... ............. ..........[J 1!J d. receive the promise for life of either payments, benefits or care?............................................................[] r:xJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................................................................................................ ....0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ rx 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?................................................................................................................. . [xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemPB transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1502 EX+ (6-98) SCHEDULE A REAL ESTATE COMMONVVEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford 0 FILE NUMBER 21-07-0009 All real property owned solely or as a tenant in common must be reported at fair mar1<et value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Real Estate - 4717-A Charles Road Mechanicsburg, PA 17050 (see settlement sheet attached) 670.46 TOTAL (Also enter on Line 1, Recapitulation) 670.46 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) Rev-1503 EX+ (6-98) . SCHEDULE B STOCKS & BONDS COMMONI/\IEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Ebersole, Wilford D FILE NUMBER 21-07 -0009 ESTATE OF All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 Prudential Financial - Stock Sale proceeds 6.870.24 2 Prudential Financial - 13 Shares Prudential stock 1.152.53 redemption TOTAL (Also enter on Line 2, Recapitulation) 8.022.77 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford D FILE NUMBER 21-07 -0009 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Bank of America - Interest Refund VALUE AT DATE OF DEATH 17.08 2 Fairfield Resorts - Reimbursement of Special Assessment/Maintenance Fee by Donald Ebersole, Purchaser 225.36 3 Fairfield Time Share - Refund of Maintenance Fee 62.50 4 Internal Revenue Service - 2006 Income tax refund 2.119.00 5 PA Central FCU - Close out account balance 809.19 6 PA Central Federal Credit Union 2.595.79 7 PA Department of Revenue - 2006 PA income tax refund 105.00 8 PSECU 538.11 9 Refund - American Home Patient 124.00 10 Reimbursement of household expenses - Expenses reimbursed by tenant remaining in residence 3.929.89 11 1994 Chevrolet Cavalier 475.00 12 2000 Chevrolet 1500 Van 6.450.16 13 Miscellaneous Personal Property 815.00 14 Time Share - Fairfield Willamsburg at Kingsgate (see attached valuation) 2.700.00 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 20.966.08 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford D FILE NUMBER 21-07 -0009 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DE~CRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. 1 Prudential Financial Annuity - $55,570.40 paid 0.00 0.00 directly to beneficiaries - 15% ($8,335.56) to Christian Life Assembly 2645 Lisburn Road, Camp Hill, PA 17011 35% ($19,449.64) to Chad W. Ebersole, Son 414 S. Market Street, Apartment 4, Mechanicsburg, PA 17055 35% ($19,449.64) to Donald P. Ebersole, Son 2001 Red Bank Road, Lot 208, Dover, PA 17315 5% ($2,778.52) to Donna Deaven, Friend 145 East Main Street, 1st Floor, Mechanicsburg, PA 17055 5% ($2,778.52) to Patrick K. Ebersole, Grandson clo Donald P. Ebersole 2001 Red Bank Road, Lot 208, Dover, PA 17316 5% ($2,778.52) to Ruth Ebersole, Friend 298 Colonial Road, Apt. 3, Harrisbug, PA 17109 TOTAL (Also enter on Line 7, Recapitulation) 0.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford D Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07 -0009 ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 9,735.92 B. 1. ADMINISTRA TIVE COSTS: Personal Representative's Commissions Donna J Deaven Social Security Number(s) I EIN Number of Personal Representative(s): 182-56-7848 Street Address 145 E. Main Street, 1st Floor City Mechanicsburg State ~ Zip 17055 Year(s) Commission paid 2007 1,000.00 2. Attorney's Fees Diane G Radcliff, Esquire 5,470.85 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 330.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 523.33 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 17,060.10 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford 0 FILE NUMBER 21-07 -0009 ITEM NUMBER DESCRIPTION AMOUNT 1 Parthemore Funeral Home & Cremation Services 1.650.26 2 Parthemore Funeral Home & Cremation Services 8.085.66 Subtotal 9.735.92 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX. (6-98) *' SCHEDULE H-82 ATTORNEY'S FEES continued COMMON~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford D FILE NUMBER 21-07 -0009 ITEM NUMBER 1 DESCRIPTION Diane G. Radcliff, Esquire - Attorneys Fees through 9/12/2007 AMOUNT 4.870.85 2 Reserve for additional attorney's fees - Reserve for First and Final Account and Final Distribution Documents 600.00 Subtotal 5.470.85 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) Rev.1502 EX+ (6-98) *' SCHEDULE H-84 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford 0 FILE NUMBER 21-07 -0009 ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills 330.00 Subtotal 330.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H-B7 OTHER ADMINISTRA TIVE COSTS continued COMMONIJIIEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford D FILE NUMBER 21-07 -0009 ITEM NUMBER DESCRIPTION AMOUNT 1 Chuck Bricker Auctioneer - Personalty Appraisal 100.00 2 Cumberland County Law Journal - Legal Advertisement 60.00 3 Cumberland County Law Journal - Legal Advertisement 15.00 4 David Frank - Trash/Personal Property Removal 85.00 5 Register of Wills - Filing Fee Inheritance Tax Return/Inventory 30.00 6 The Sentinel - Legal Advertisement 173.33 7 Vital Records 60.00 Subtotal 523.33 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford D FILE NUMBER 21-07 -0009 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 2000 Chevrolet Custom Van - Payoff owed to M & T Bank VALUE AT DATE OF DEATH 6.094.16 2 Accredo Health Group - Last Illness expense 7.00 3 American Home Patient - Last Illness Expense 2.180.00 4 Bank of America - Credit Card 1.374.74 5 Bank of America - Visa Interest 17.08 6 Boscovs - Credit Card 136.34 7 Comcast - Cable 242.99 8 Erie Insurance - Auto Insurance (Jan - Apr) 162.00 9 Fairfield Resorts - Special Assessment/Monthly Maintenance 637.56 10 New Cumberland Federal Credit Union - Visa 3.415.55 11 Pennsylvania American Water - Final Water Bill 105.63 12 PP&L - Electric 280.29 13 T -Mobile - Cell Phone 104.23 14 Tire Plus - Account No. 553036089 586.23 15 UPMC Presyterian Shadyside - Last Illness Expense 16.31 16 Verizon - Final Telephone Bill 194.47 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 15,556.58 (If more space is needed, additional pages of the same size) Copyright (C) 2002 form software only The Lackner Group, Inc, Form PA-1500 Schedule I (Rev, 6-98) Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford 0 FILE NUMBER 21-07 -0009 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 17 WEST AB - 2006 Local Income Tax 2.00 TOTAL (Also enter on Line 10, Recapitulation) 15.556.58 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9-00) ESTATE OF NUMBER I. *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Ebersole, Wilford D NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-07 -0009 RELATIONSHIP TO DECEDENT Do Not List Trustee(sl SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) 1 Donna J Deaven 145 E. Market Street 1st Floor Mechanicsburg, PA 17055 Chad W Ebersole 414 S. Market Street Aprt. 4 Mechanicsburg, PA 17055 Donald Ebersole 2001 Red Bank Road Lot 208 Dover, PA 17315 Patrick K Ebersole 2001 Red Bank Road Lot 208 Dover, PA 17315 Ruth Ebersole 298 Colonial Road Apt. 3 HarrisburQ, PA 17109 Friend 5% ($2,778.52) of Prudential Annuity 2 Son 35% ($19,449.64) of Prudential Annuity 35% ($19,449.64) of Prudential Annuity 5% ($2,778.52) of Prudential Annuity 3 Son 4 Grandchild 5 Friend 5% ($2,778.52) of Prudential Annuity Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS See continuation schedule(s) attached 0.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE -I-liB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ebersole, Wilford D FILE NUMBER 21-07 -0009 ITEM NUMBER 1 DESCRIPTION Christian Life Assembly - 2645 Lisburn Road, Camp Hill, PA 17011 15% ($8,335.56) of Prudential Financial Annuity AMOUNT 0.00 Subtotal 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J-IIB (Rev. 6-98) WILFORD D. EBERSOLE File No. 12-06-W ," '\ ." I (', ".(....r^/ c\ u \ '_I \)\) LAST WILL AND TESTAMENT of WILFORD D. EBERSOLE r~......j ~-; ! c; BE IT REMEMBERED, that I, WILFORD D. EBERSOLE, of 4714 A Charles Road, MechanicslijJrg, PA 17050, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me, at anytime heretofore made. ARTICLE 1. BACKGROUND INFORMATION: The following is background information pertaining to myself and my family: A. I was born on June 7, 1943. B. I am divorced. C. I have two (2) children, to wit: Donald P. Ebersole, born October 6, 1967; and Chad VI . Ebersole, born March 5, 1971. ARTICLE 2. DEFINITIONS AND MISCELLANEOUS TERMS: The following definitions and miscellaneous terms shall apply to this my Last Will and Testament: A. My Children: The term "my Children" includes the children referenced in Article 01 above, if any, and any children born to or adopted by me after the execution of my Will. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purposes of succession to property under my Will. B. Issue: The terms "issue" as used in my Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to, who are in being at the time they must be ascertained in Order to give effect to the reference to them. C. Per Stirpes: The term "per stirpes" as used in my Will means that whenever a distribution is to be made to the issue or descendants of any person, the property 1i%- Initials WILFORD D. EBERSOLE File No. 12-06-W to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are living, of the person. Each living child, if any, shall take one share and the share of each deceased child shall be divided amongst his then living descendants in the same manner. E. Per Capita: The term "per capita" as used in my Will means that whenever a distribution is to be made to a person, the property to be distributed to that person shall be distributed only if that person survives me. If that person has not survived me, the distribution to that person shall lapse and be deemed void. F. Personal Representative: The term "Personal Representative" as used in my Will means the Executor or Executrix of my Estate, or any other title of like import which is used to describe such a fiduciary. G. Residuary Estate: The term" Residuary Estate" as used in my Will means all the rest, residue and remainder of my Estate remaining after payment of all of my last debts, funeral expenses taxes and administration expenses and any other expense, or expenditure required to be made as the result of my death and after distribution of the Tangible Personal Property and any special bequests specifically set forth herein. H. Survival: The term "survive me", or any derivative thereof, as used in my Will means that any person or organization herein named or referred to shall be deemed to have survived me only if such person or organization shall in fact survive me for a period of at least thirty (30) days. Any person or organization named or referred to herein who shall not survive me by a period of thirty (30) days shall be deemed to have died before I do. I. Gender and Number: Where appropriate to the context, pronouns or other terms expr-essed in one number or gender shall be deemed to include the other number or gender, as the case may be. J. Percentages: Where a gift, bequest or devise is expressed as a percentage in the following Articles, it refers to the percentage of that portion of my gross estate available for distribution unless a contrary intention appears in the Article. yJ[~ Initials '} WILFORD D. EBERSOLE File No. 12-06-W K. Priority: Priority for distribution of the gifts and bequests herein made shall follow the Article number with the lower numbered Article taking priority over any Article appearing subsequently unless a contrary intention appears in the Article. L. Encumbrance: When encumbered property has been specifically devised or bequeathed, it shall pass under the terms and conditions of this Will subject to said encumbrances, provided however, that any installment payments, current or past due, on either principal or interest on such encumbrances may be paid by my Personal Representative in his/her sole discretion. M. Partial Invalidity: If any provision of this Will shall be declared inoperative or in violation of any rule of law, such invalidity shall not affect the remaining provisions of this Will and they shall remain in full force and effect. ARTICLE 3. BURIAL INSTRUCTIONS: I direct that I be buried with full military honors at Fort Indiantown Gap and that any necessary funeral arrangements be handled by the Partemore Funeral Home of New Cumberland, PA. ARTICLE 4. DEBTS AND FUNERAL EXPENSES: I direct that all my just debts and funeral expenses appropriate to my station in life and custom of living (including appropriate monument or marker for my grave) be paid as soon after my demise as may be convenient. ARTICLE 5. ADMINISTRATION EXPENSES: I direct that all of the expenses of the administration of my Estate including, but not limited to, probate and other Court fees and reasonable commission for my Personal Representative and any attorney retained by my Personal Representative, be paid as such expenses are incurred and as soon after my demise as may be convenient. ARTICLE 6. PAYMENT OF TAXES: I direct my Personal Representative to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my Estate or any person receiving the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes against my Residuary Estate, it being my intention that none of the aforesaid taxes, either federal or state, or any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my Estate to whom such property is or may be transferred or to whom any benefit accrues. tv'L- Initials ':1 WILFCRD D. EBERSOLE File No. 12-06-W ARTICLE 7. TANGIBLE PERSONAL PROPERTY: I give and bequeath all tangible personal property owned by me at my death and all insurance policies on such property as follows: A. Memorandum: To those individuals who survive me and who are designated on a list, memorandum, or Bequest of Personalty form signed by me which refers to my Will or is found with a copy thereof, I give and bequeath the item or items of tangible personal property listed beside his/her name. B. Remainder Distribution: The balance of my tangible personal property (including any items to be distributed under this Article, the bequest of which has lapsed) shall become part of my Residuary Estate and distributed to the beneficiaries and in the proportions herein provided. My Personal Representative shall have the right to dispose of said remaining items of personalty, either in kind or in cash as a result of liquidation thereof as my Personal Representative, in my Personal Representative's sole discretion, deems appropriate under the circumstances. It is my intent, however, that should any beneficiary of my Residuary Estate desire to receive a particular item in kind which was not specifically bequeathed to that beneficiary, to the extent reasonably possible, my Personal Representative shall attempt, but not be obligated, to follow that beneficiary's request. C. Safekeeping: If any beneficiary of any item of tangible personal property aforesaid has not yet attained the age of eighteen (18) at the time of my death, I direct that my Personal Representative, hereinafter named, to hold said items in safekeeping for that beneficiary and to deliver the same to that beneficiary upon he or she reaching age eighteen (18), or at such earlier age if my Personal Representative deems the beneficiary to be of appropriate age and maturity to receive said items of personalty. For these purposes my Personal Representative shall be entitled to use or set aside from my Estate sufficient funds to provide for that safekeeping. ARTICLE 8. SPECIAL BEQUESTS: I give and bequeath the amount of $10,000.00 to my friend and companion, Donna Deaven. ARTICLE 9. RESIDUARY ESTATE: The following shall apply regarding distribution of my Residuary Estate: A. I give, devise and bequeath my Residuary Estate to my sons, Donald P. Ebersole and Chad W. Ebersole, or either of them who survive me in equal shares per capita. 1~'s L1 WILFORD D. EBERSOLE File No. 12-06-W B. Should Donald P. Ebersole and Chad W. Ebersole both fail to survive me, the share distributable to my said sons shall lapse, in which event I then give devise and bequeath my Residuary Estate to the issue of sons, Donald P. Ebersole and Chad W. Ebersole, or such of them that survive me in equal shares per stirpes. ARTICLE 10. APPOINTMENT OF PERSONAL REPRESENTATIVE: The following shall apply to the appointment of my Personal Representative: A. I appoint Donna Deaven as my Personal Representative. B. Should Donna Deaven predecease me, die, fail to qualify, cease to act or renounce the appointment as my Personal Representative, I then appoint Chad W. Ebersole as my Personal Representative. C. Should Chad W. Ebersole predecease me, die, fail to qualify, cease to act or renounce the appointment as my Personal Representative, I then appoint Donald P. Ebersole as my Personal Representative. ARTICLE 11. POWERS OF PERSONAL REPRESENTATIVE: In addition to the powers conferred by law or under previous provisions of my Will, my Personal Representative shall have the following powers: A. Retention of Investments: To retain investments I may have at my death when deemed advisable to my Estate or trust to do so; B. Sale of Assets: To sell either at public or private sale any real or personal property and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title with special warranty, free and clear of all trusts and without obligation or liability to the purchaser or purchasers to see to the application of the purchase money or to make inquiry to the validity of the sale or sales; and to make, execute, acknowledge and deliver any and all deeds, assignments, options, or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Personal Representative or otherwise; C. Investment: To vary investments, when deemed desirable, then to invest in such bonds, stocks, notes, real estate mortgages, or other securities, or in such property, 1 /((' ~ Initials 5 WILFORD D. EBERSOLE File No. 12-06-W real or personal, as deemed wise, without being restricted to so-called "legal investments" and without regard to diversification; D. Management of Real Estate: To manage real estate; E. Options: To exercise any option or rights arising from ownership of investments; F. Compromise of Claims: To compromise claims without Court approval and without the consent of any beneficiary; G. Disclaimer: To disclaim any interest in property; H. Elective Share: To claim an elective share of the estate of any deceased spouse I may have; I. Joinder in Tax Returns: To join with any spouse I may have in the filing of any federal income tax return for any year for which I have not filed such return prior to my death, and to consent to the treatment of any gifts made by my spouse as being made one- half by me for gift tax purposes notwithstanding the fact that such action may result in additional liabilities for my Estate. Any income or gift taxes due on such returns and any deficiencies, interest, penalties, or refunds thereon, shall be allocated between my Estate and my spouse and my spouse's estate, or all to any of them, in such manner as my Personal Representative and my said spouse may agree; J. Payment of Cost and Expenses: To pay all costs, taxes, expenses and charges in connection with the administration of my Estate or trust, including but not limited to my last debts and all funeral expenses; K. Division and Distribution: In Order to effectuate a division of the principal of my Estate or of any trust or for any other purpose, including final distribution, my Personal Representative is authorized to make such divisions or distributions of the personalty and realty in kind or by way of liquidation thereof in whole or in part as my Personal Representative may deem appropriate under the circumstances. If a distribution or division is made in kind, said assets are required to be divided or distributed at their respective values on the date or dates of their division or distribution. ARTICLE 12. NO BONDING REQUIREMENT: I direct that my Personal Representative, or 1'ik -' Initials 6 WILFORD D. EBERSOLE File No. 12-06-W successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ARTICLE 13. EXCLUSION: It is not my intention to make provision in my Will for any relative or any other person not expressly provided for herein, except for children born to or legally adopted by me after the date of this instrument. If any such person has not been expressly mentioned herein, he or she has been omitted by me intentionally and with full knowledge of his or her relationship and existence, and not by any oversight or neglect. ARTICLE 14. WILL CONTEST: In the event that any person, including a devisee, legatee or beneficiary under my Will shall either directly or indirectly seek to establish or assert any claim to my Estate, or any part thereof, not authorized by my Will, or seek to impair, invalidate, or set aside the provisions of my Will, or to have any of the trust provisions or estate distributions limited, declared void or diminished or to defeat or change any of the dispositive scheme of my Will, or shall endeavor to secure or take any part of my estate in any manner other than through or under my Will, I hereby give, devise and bequeath to such person or persons the sum of Ten Dollars ($10.00) and no more in lieu of any other share or interest in my estate. Provided further that nothing in this Article contained shall prevent any beneficiary hereunder from bringing an action against any fiduciary hereunder, for an accounting, nor from enforcing any statutory share to which the beneficiary may be entitled. r<:L C' ~ IN WITNESS WHEREOF, I have hereunto set my hand and seal thisG.i2.:- day of tL(jLJ.-/, 2006. WITNESS: ..._-------..---.. ('''''''' \ ~, "-- ~~\/l.C~.._... . -'-L__.__. , l~..") /..., ".. 0/ ! // fI{ / /-.-., I "..... ~.__._\<._- I: \~ 7Ltk[~JSEAL} 7 WILFORD D. EBERSOLE File No. 12-06-W ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA 55. COUNTY OF CUMBERLAND We, WILFORD D. EBERSOLE, Diane G. Radcliff, Esquire, and l~L \,~ ~. CCL-, (i (J the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as the Testator's Last Will and Testament and that the Testator had signed willingly (or willingly directed another to sign for the Testator, and that the Testator executed it as the Testator's free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 1L/.~lVc;f:rj~hL<Y-L - {SEAL) -~t r __---'_' \ ~ C. i~ I \--l:)J:- It /:-~ J J;W1TN"E)s --<, '~i . .'. /-7 ,/ '" , './ / / .. I A' .'-' \ ....- ,,"" _...x',....__...___.__- WITNESS Sworn to and subscribed to before me this).;/,J day of , 2006. / /'1 '/ ,. NOTARY PUBLIC COMMor~W:::f\L iH OF fOE~JNSYLVANIA ----.~j:)tcHial Sea!' 1 Deborah 1._. Doniey, Notary PU~bic Camp Hil! Bom, Cumbel1and County My Commis':'ion _Ei><i:~ir:::::?t 23. 2007 Member. P~Hln8vlvl~ilt-l /'''f,Sl\('jd~ion Of Notaries My Commission Expires: 8 WILFOR.D D, EBERSOLE File No. 12-06-W BEQUEST OF PERSONAL TV Pursuant to the terms of my Last Will and Testament dated A-0Go"'Sr 2.2- ,2006, I, WILFORD D. EBERSOLE, hereby give and bequeath the following items of personal property to the person or persons whose names appear next to each said item of personalty, to the extent that I own said items as of the date of my death: 1. To my former wife, Ruth Ebersole, my banjo. 2. To my friend, Donna Deaven, my 1994 Chevrolet Cavalier. 3. To my friend, Donna Deaven, my 2000 Chevrolet Express Van. These bequests supersede, replace and revoke all prior bequests of per~\ alty. t~ ~ ) IN WITNESS WHEREOF, I have set my hand and seal this ;;22 day of LCL7-.~/T ,20~. U ~ITNESS: (/'" \~, '--- \ r '('; j. ~ ~~'_// ----.- . ' ?@ ", 1,/" I (//~_ - I ',,- ~ _.. t. ," 1L,"tJ;tC~{~0LtYLj (SEAL] WILF ,,0 D. EBERSOLE -' \ 1 WILFORD D, EBERSOLE File No. 12.06.W ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : 55. COUNTY OF CUMBERLAND We, WILFORD D. EBERSOLE, Diane G. Radcliff, Esquire and ~,I 18 S , G:ul~) fl , the Testator and the witnesses respectfully, whose names are signed to the attached or foregoing Bequest of Personalty, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as Testator's Bequest of Personalty and that Testator had signed willingly (or willingly directed another to sign for Testator) and that Testator executed it as Testator's free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Will as witnesses and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. if- ~i#lr:/k'2G tTL- {SEAL] ~ILF RD D. B RSOLE \ (' ;. \ '~"( r \ .~ . : ~-~ \. \ . ~\ --.---... i/-wITNEs~S .~./.. ./". ."~ / ,.'. f' ;' l---"~ ... i'- ~" I ' ~. ~~-.._,- WITNESS \ Sworn to and subscribed to before me this.::,,/J'day of , 202-.. // i I / Notary Public My Commission Expires: r()f0,i\lIl!!>J.Y~'i;:,:i:;;~;:,~:'~}~ N SYLVANIA I Detl0rail i., fj"ilPY. Notary Public CarTlp :-lii' C~""" "Jml".,nantj Coooly MV,C'\flln"':"'", " "",i,I',; Sept. 23, 2007 \klllbp1 i)C'~ri!-':.'\I/'v:;r;'I'.~:-':_\:~~;:;;ti;n Of Notari'es: 2 B NO. 2502-0265 "1r A B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1DFHA 2.0FmHA 3 DCONV UNINS 4.0VA 5.0CONV INS 6. FILE NUMBER: 17 LOAN NUMBER: SETTLEMENT STATEMENT 07-140 205873 8. MORTGAGE INS CASE NUMBER: OLD MORTGAGE INS CASE NUMBER 745/F/5.875% SKS C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown Items marked ''[POC]'' were paid outside the closing; they are shown here for informational purposes and are not included in the totals 10 3/9S (BAIR, MATTHEW PFDJ07 -140116) D NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Matthew W. Ba" and Estate of Wilford D. Ebersole MEMBERS 1ST FEDERAL CREDIT Stacie R: Samsel UNION 4714A Charles Road 5000 Louise Drive Mechanicsburg, PA 17050 Mechanicsburg, PA 17055 G PROPERTY LOCATION H. SETTLEMENT AGENT 25-1857112 I SETTLEMENT DATE: 4714A Charles Road Midstate Abstract Company Mechanlcsburg, PA 17050 March 30, 2007 Cumberland County. Pennsylvania PLACE OF SETTLEMENT 2331 Market Street Camp Hill, PA 17011 J SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101 Contract Sales Price 129,90000 401. Contract Sales Price 129,90000 102 Personal Propertv 402. Personal ProD'ertv 103 Settlement Charnes to Borrower (Line 140m 4,11441 403. I 104. 404. I 105 405. AdlUstmenls For Items P8Id Bv Seller in advance Adiustments For Items Paid Bv Seller in advance 106 CltvlTown Taxes to 406. CitvlTown Taxes to 107 County Taxes 03/30/07 to 01/01108 22048 407. County Taxes 03/30/07 to 01/01/08 22048 108 School Taxes 03/30/07 to 07/01/07 272.84 408. School Taxes 03/30/07 to 07101107 272.84 109 Sewer Proration 03/30107 to 04101107 2.86 409. Sewer Proration 03/30/07 to 04/01/07 286 110 March Association Dues 03/30/07 to 04/01107 548 410. March Association Dues 03/30/07 to 04/01/07 548 111 411. 112 412. 120 GROSS AMOUNT DUE FROM BORROWER I 134,51607 420. GROSS AMOUNT DUE TO SELLER 130,401 66 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201 DeDas I! or earnest monev 2,000.00 501. Excess DeDosit (See Instructions) 202 PrinclDal Amount of New Loan(s) 126,00000 502. Setttement Charoes to Seller (Line 1400\ 10,04554 203 EXlstJnq loan(s) taken subect to 503. Existinq 10arl!S\taken subiect to 204 504. Payoff of first Mortgage to SunTrust Mortgage, Inc 119.385.66 205 505. Pavoff of second Mort aae 206 506. 207 507. IDeoosit disb. as oroceeds) 208 508. 209 Seller Credit 300.00 509 Seller Credit 300.00 Ad ustments For Items Uno aid Bv Seller Adiustments For Items Unoaid Bv Seller 210 Cilv/Town Taxes to 510. CitvlTown Taxes to 211 Countv Taxes to 511. County Taxes to I 212 School Taxes to 512. School Taxes to 213 513. 214 514. 215 515. 216 516. 217. 517. 218 518. 219 519. 220 TOTAL PAID BY/FOR BORROWER 128,30000 520. TOTAL REDUCTION AMOUNT DUE SELLER 129,73120 300, CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301 Gross Amount Due From Borrower (Line 12m 134,516.07 601. Gross Amount Due To Seller (Line 420\ 130,40166 302 Less Amount Paid By/For Borrower (Line 220) ( 128,300.00) 602. Less Reductions Due Seller (Line 520) ( 129,731.20 303 CASH ( X FROM) ( TO) BORROWER 6,21607 603. CASH ( X TO) ( FROM) SELLER 670 46 OM The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any atta9hments referred to herein. /.,~ ,,' / / ,/ ./'f ,-, Borrower seller;/~~/ ~ ; ~ '--ESlate 6'twil~er Ie ~ c--- , L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price $ 129,90000 (Q) 6.0000 % 7,79400 PAID FROM PAID FROM Division of Commission (line 700) as Follows. BORROWER'S SEL lER'S 701. $ 3,92200 to CENTURY 21 AT THE HELM FUNDS AT FUNDS AT 702. $ 3,87200 to RE/MAX REALTY ASSOCIATES SETTLEMENT SETTLEMENi 703 Commission Paid at Settlement 7,79400 704. Transaction Fee to RE/MAX Realty Associates, Inc 175.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ono;nallon Fee % to 802 Loan Discount % to 803 Appraisal Fee to 804 Credit Report 10 805 Lender's Inspection Fee to 806 Applicallon Fee to MEMBERS 1ST FEDERAL CREDIT UNION POC B $50.00 300.00 807 Assumption Fee to 808 809 810 811 900. ITEMS REQUtRED BY LENDER TO BE PAID IN ADVANCE 901 Interest From 03/30/07 to 04101/07 @ $ 20.280800/day ( 2 days %) 40.56 902 Mortgage Insurance Premium for months 10 903 Hazard Insurance Premium for 1.0 years to 904 905 1000. RESERVES DEPOSITED WITH LENDER 1001 Hazard Insurance months $ per month 1002 Mortoaoe Insurance months D $ 84.00 oer month 1003 C ItvlT own Taxes months $ oer month 1004 County Taxes 2.000 months $ 24.21 per month 48.42 1005 School Taxes 10.000 months @ $ 87.45 per month 874.50 1006 montns -@ $ p'er month 1007 monlhs "" $ ner month 1008 Aaareaate Adiustment months (Q) $ ner month -32016 1100. TITLE CHARGES 1101 Settlement or Closina Fee to 1102 Abstract or Title Search to 1103 Title Examination to 1104 Title Insurance Binder to 1105 Electronic Document Prep. to 1106 Closino Service Letter to Midstate Abstract Comoanv 3500 1107. Attorney's Fees to Diane G. Radclitf, Esquire Deed Prep/Attendance 20000 (includes above item numbers: ) 1108 Title Insurance to MIDSTATE ABSTRACT Basic -25% PHFA 756.56 (Includes above Ilem numbers.1102, 1103 & 1104 ) 1109 Lender's Coverage $ 126,00000 1110 Owner's Coverage $ 129,90000 756.56 1111 Endorsements 100, 300, 8.1810 to Midstate Abstract Company 200.00 1112. Notary Fee to Midstate Abstract Company. 10.00 1113 Notary Fee to Midstate Abstract Company 5.00 11'14 Overnight Fees & Handling to Midstate Abstract Company 15.00 15.00 1115 Transaction Fee to Century 21 At The Helm 12500 1116. Feb/March/April Assn. Dues to SI. Mark's Place Condominium Association 8500 170.00 1117 Sewer to Hampden Township Municipal Authority 12853 14202 1118 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201 Recording Fees: Deed $ 40.50; Mortgage $ 74.50; Releases $ 11500 1202 City/County Tax/Stamps' Deed 1,29900 Mortn-ane 1 ,299 00 1203 State Tax/Stamps' Deed 1 ,299.00; Mortoaae 1,299.00 1204 Asslanment of Mortaaoe to Cumberland County Recorder of Deeds 27.00 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301 Survey to 1302. Pest InsDection to Enviroouest & Home Insc. 325.00 1303 2007 CountvlTw';'Taxes to Marie Huber, Treasurer 10-21-0279-374-U24 290.52 1304 Tax Certification to Diane G. Radcliff, Esm,ire 5.00 1305 1400. TOTAL SETTLEMENT CHARGES rEnter on Lines 103, Section J and 502, Section K\ ./? 4,11441 10,04554 Qy SI]IlIIIg page 1 of Hlis statement. the signatories a<:krlowledge receipt of a camp/eled copy 01 page 2 of this two page slatement ~ Page? Certified to be a Irue copy Midstate Abstract Company Settlement Agent {OI-140/07-140/ 16 i ---- lomputershare Computershare Shareholder Services, Inc PO Box 43033 Providence Rhode Island 02940-3033 Telephone: 800 305 9404 www.computershare.com/prude ntia I -t Prudential ~ Financial I/MPORTANT TAX RETURN DOCUMENT ENCLOSEDI = - - WILFORD D EBERSOLE 4714 CHARLES RD #A MECHANICSBURG PA 17050-7717 ---- = ---- - 1,1.1111,1111....1.1.11...111.11,,11,,11111,11.,111111,11/...1 Holder Account Number - C 0016139068 INO 1m 1111111111111111111111 SSNfTlN Certified Symbol Yes PRU 00 I CS 0093 .DOMEQSB LUEBG.C1S.63241_134/000 145/000 145/i Prudential Financial, Inc. - Sale Advice /2006 Tax Form 1099-8 This is Important tax infonnaUon and is being penally or other sanction may be imposed on WILFORD D EBE Recipient 4714 CHARLES R #A MECHANICSBURG PA 0016139061 16134439~ 43-191274( 1545-071 Department of the Treasury - Internal Revenue Servi< NOTE: Computershare wiU rep you recei Form 1 099-8 (Keep for your records) Summary Trade Date . .. I Shares/Units I Price Per I Gross Amount I Transaction Descnptlon Sold Share/Unit ($) of Sales ($) Deduction I Amount ($) Deduction I Type Net Amoun of Sale ($ 19 Dec 2006 Sale 80.000000 86.095506 6,887.64 17.40 Transaction Fee 6,870.24 Computershare Trust Company, N.A., as agent, upon written request, will provide the name of the executing broker dealer associated with the transaction(s), and within a reasonable amount c time will disclose the source and amount of compensation received from third parties in connection with the transaction(s), if any. . 71UTX PRU -f 001 COloooa OOHX2E -- Prudential ~ Financial lomputershare + = - --- = --- - 000113 I'MPORTANT TAX RETURN DOCUMENT ENCLOSEDI Computershare Shareholder Services, Inc PO Box 43033 Providence Rhode Island 02940-3033 Telephone 800305 9404 www.computershare.com - - - DONNA J DEAVEN EX EST WILFORD D EBERSOLE 4714 CHARLES RD #A MECHANICSBURG PA 17050 I111II11111111111111111111111111111111111111111111111111I11111 Holder Account Number = --- = = = - - = C 0029864292 FID IIII "" I "" I" 1111111111 SSNITIN Certified Symbol Yes PRU 00 lCSIIII'!3.DOMLQSBI.UEB(i.CIS.6.12.13_1 Y2/1100 113/1100 113iJ Prudential Financial, Inc. - Sale Advice /2007 Tax Form 109.9-8 .- 0 Corrected (if checked) Copy B - For Recipient Account Number 0029864292 Form 1099-B - Proceeds from Broker and Barter Exchange Transactions 2007 Recipient's 10 no. 207210538 Payer's Federal 10 No, 43-1912740 This is important lax infonnation and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence OMS No. 1545.07151 penalty or other sanction may be imposed on you if this income is taxable and the IRS detennines that it has not been reported. Department of the Treasury - Internal Revenue Service I DONNA J DEAVEN EX EST WILFORD D EBERSOLE I Recipient 4714 CHARLES RD #A I MECHANICSBURG PA 17050 ~ Date of Sale F CUSIP No. I Stocks, Gross Proceeds I Payer's Details or Exchange Bonds, etc. ($) Reported to IRS 07 Mar 2007 744320102 1,164.57 Yes COMPUTERSHARE SHAREHOLDER SERVICES INC ~ FEDERAL INCOME r 71 ., P.O. BOX 43010 TAX WITHHELD ($) Descnptlon: Name of Issuer Transaction PROVIDENCE RI j 0.00 PRUDENTIAL FINANCIAL INC Sale - C01 NOTE: Computershare will report the amount in Box 2 to the IRS. The difference between the gross proceeds amount in Box 2 and the net proceeds you received represents any fees, charges, or withhoiding taxes you may have paid. Form 1099-8 (Keep for your records) Summary Trade Date I Shares/Units I Price Per I Gross Amount I Transaction Description Sold Share/Unit ($) of Sales ($) Deduction I Amount ($) Deduction I Type Net Amount of Sale ($) 07 Mar 2007 Sale 13.000000 89.582220 1,164.57 12.04 Transaction Fee 1,152.53 Computershare Trust Company, N.A., as agent, upon written request, will provide the name of the executing broker dealer associated with the transaction(s), and within a reasonable amount of time will disclose the source and amount of compensation received from third parties in connection with the transaction(s), if any. . 71UTX P R U + 001CD70008 OOHX2E . -. ~ \),\ ~ ~ ~ ~ ~ ~ () n :J u J :J ~ COllJllJeree- e' D .I~ America's Most Convenient Bank@ Dan" 1-888-937-0004 commercepc.com I Balance information reflects tranactions through 6:00 PM on that business day. Some deposits may not be available for immediate withdrawal. Checks and other items are received for deposit subject to the provisions of the Uniform Commercial Code or any applicable collection agreement. 14 DDA t)2POSl1 J ;..~..:l .1-'.-' i BR-17-HB (2/06)tf) 1MM9/06AC ~f} &nTTLX- Feu...- CHECKS AND OTHER ITEMS ARE RECEIVED FOR DEPOSIT SUBJECT TO THE PROVISIONS OF THE UNIFORM COMMERCIAL CODE OR ANY APPLICABLE COLLECTION AGREEMENT. )> () () ;-; ~ o z )> ;s:: ~ ~~ ~" i~ ~ ~ ~ r m en en () )> en :r y o )> -I m "'- !~ ~~ ~ a, ~ ~ ~ ~ I~ ~ ~ ~ '" ~ ::;; :i! ~ ::;; r. n -~ gJi ~~ ~CD o c:I: :I:mm >"'00 :cOO :ccnZ (i;::jC> lXl-l> e:-O :cOo C>"o me: -Iz -I ~ en :r () c :D :D m z () -< y .~. '-'\ ~ ~ ~. "() .~ (ll ~ <->t . . ~ ~ B-18-HB (REV. (4105) 12; 25Pt'i CA1~lF 01./18./07 11 ll1; \ niLL >1Di j i n,;...L t~~~f:;47D $2 ,Sij5 " 7;:1 i [' Gpd-JO (f / /) At,L e :;; t:-r 00-1-1 ,,:::oIO om m :::0 .. o --: J:-. C :E ...-..: .;0..: . . i ~ &;- ~[IJ ~~~lll ~ mr- Q ~ jj )> a 0 r ms:: y y - -u ..[] L11 L11 ~. , , :r: ~ t::: "I ",:,,"0. 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"" )i: * ..:.. -.. ..... -.. ..... ~~~~ * lr: :;: IJ:.; :;: fJl ::c to ~II l>CJ1 ::0 to ::0 - m "'l> ""'" '-in C-i ::0 EICI "'.." )> ..,,::0 ~I:I l>'" .... ... ~ '" ~l" ""'::0 < ;IIJ m zi_ .....j :..D < ~ 0 6 en .~ > :..:.: :!I ~ -' m -J :c co (D 0 c c.n "')>0 c.n ~~ :..:::: ":0: ~ :_': ..:-: a, ,-': G ...., 01 .....1 ~ rv :i '" /' ~~ ~~ !~ ESTATE OF WILFORD 0 EBERSOLE fiB 3448 TRINDLE ROAD ~~ CAMP HILL, PA 17011 ~~ ~~ ;~ ? 100L/la? ~~ DATE DEPOSITS MA Y NOT BE A VA/LABlE FOR IMMEDJA TE WITHORA WAL n ~ffi ~j ~8 ~~ ~~ ~~ ~~ ~~ DEPOSIT TICKET CASH ~ 04-07 -~ gOt./ ? /Os-.OO ___,J I -..-__-----.J' OAIOTALFROMOTHl'AS,OE SIGN HEREIFCASiTRECEIVED FROM DEPOSIT TOTAL o SUBTOTAL~ Commerce .. Ba'''''- America's Most Convenient Bank" ., ..n 1-888-937-0004 LESS CASH ~ NET DEPOSIT $ <1 / i./ r .:502.1110.8....: S~ 7~"'b"'7 Dill PA Central WS 19360 60-8755/2:: FEDERAL CREDIT UNION VOID AFTER 90 DAYS (i-) 1 (:r::~t_:}(a ..J 1.1.1 1 '":) (.~) ';.:.' DATE !I; !:l ~;J'::J" :L;:":) PAY E:: :i. I] h t: H U 'n d T- (,'f d i'.1 i 'n i!~ <:'. '1 i d :l. ':) /' :I. rl (.~I')(' .)f .)(. ')(H)(")H(' .)~ ')H( .)(- ,)(. .)~ ,)(. -)'; .)~ .)( ')';-:11:' .)(. :,(, ')HHHH(' .)(. .)(, .)(. -.\., .)" 959 EAST PARK DRIVE HARRISBURG, PA 17111 TO FSTr::nT: DF !.,JII...FOF<:D D i:::BE::F:~::;DLE THE ORDER OF PAYABLE THRU MID-ATLANTIC CORP. F.C.U. MI~.~ AUTHORIZED SIGNATURE 1110 . g ~ b 0 III .: 2 ~ . ~ 8 7 5 SO.: III 2 ~ . ~ 8 . .0 :1 0 2 bill ." ., "; ;;'.:::.:1-:'i':'l'" ":."f,;):",'e',";_:.-!;(;';: PAY~DD ONLYY~CTSCTS TO THE ORDER OF 670266 00000 001 018 I 'CDC FUND DEPT ---'- *~ o ':,. =' w~ . . o 0, , 0- o . o 0_ - ......= - 0_ CJ1 0= 0' *.- /'" <-".c,,--';"',:-,;,"":":' ,',;,:,.:...- ,-". :.'.,',c,:,: '--,c::'c.., '. ,-'" '.' " '" ' :"',. _, <:, 'c'" -:_<',_ .__',_::,.".,....,' " '" ' ,', , F,uLTofiJ{W,NK LA.NC,4.ST~R,\A VERIFIQATION AVAILABLE - "POSITIVE PAYi'PROTEQTEb WILFORD D EBERSOLE DLN 061010819836 REV REFUND O/OUNIT A 4714 CHARLES RD MECHANICSBURG PA 17050-7717 1...111...111....1.1.11...1...11...1...111...1...11.1..111.i.1 VOID AFTER 180D.AYS $ '.~:~0~~.~:~.~~~'~~$':1;Q~"~iiip. ... o co N o o ~_/?~.. .....-./UtMO- 1-~-t~f~NNSYLVANfA III 5 5 ... :3 8 2 8 7 III .: 0 :1 . :1 0 . ... 2 2.: . 2 . I:i 5:1 8 ... 7 III I I DO NOT -ACCEPT WITHOUT HOLDING TO LIGHT TO Vj::RIFY WATERMARKS. -- "'0 ~~~~ U.l t; t: g ~ Q:J:I:z ~ ffi~~~ ~ ~~~~ ~ ~~~~ \ All c: .. ";:: ~ S -". lS8 ::0, CO." ~~ ..", ~~ Q,).::::: ~c:: Q,)~ ~- cS 14tl)!~~~~~~"-~~ ffi ~ \1 z o " [;J ::J 8 ~ ~ ~ D~ ~ ~ ~ o w 8 < g ~ ~ 8 ~ Ii' ~ ~ ~ IJ1 0 ~ o u; .. .> - ~ W I ~ (:> ~ U o ~ ~ U; ::. ~ ru ~ Ii' o ~ U1 ~ .. ~ ~ < ~ ~ ~ " Z < W ~ ~ U ['- ..r c.J] ..r ~ ['- ..r CC ... I _ Kelley Blue Book THE TRUSTED RESOURCE kblMom advertiscrnent 1994 Chevrolet Cavalier VL Sedan 40 BLUE BOOK TRADE-IN VALUE Condition Value Excellent $800 Good ./ Fair $475 (Selected) Vehicle Details Mileage: Engine: Transmission: Drivetrain: 100,000 4-Cyl. 2.2 Liter Automatic FWD Selected Vehicle Standard Air Conditioning Power Steering Power Door Locks AM/FM Stereo Blue Book Trade-In Value Trade-in Value is what consumers can expect to receive from a dealer for a trade- in vehicle assuming an accurate appraisal of condition. This value will likely be less than the Private Party Value because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. Vehicle Condition Ratings ExceUent advertisement IS In excc1lcnt no reconditioninG_ rhis vehicle has never frc:"c of rust", The vehicle has J clean title safety inspection. The cnq!ne cornpartrncnt fiee of any v,slbie deFects, The anci verifiable serVice records, Less than SO/u of ,':ill Good $675 vehicle is free of any rllajor defc(t~;, rhis history r the paint.! !)odV ZlncJ interior have oniy r-nmor arc no rnajo( n1cchanical prchlerns, "fhere no rust on thiS vehicle, The tires rnatctl and have su bstantiE:d trc ld icft. !\ ';qoocr Vehlc.le v\lll; need sonic rcccndiUonlnq to fJC soid at rct[.~iL fv1cy;t CO!lStHllcr cwncc! vehic.k's fa!! ~ntc this catcqory, ..I Fair (Selected) $475 "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition, This vehicle has a clean title history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Poor NJA "Poorl1 conditi(:Hl n1C:Jns that the vehicle has severe rncch21nica! ancJ;'or' co~)rrlf:Uc defects dncJ IS in poor l"unnrnq condiUorL The vehicle rnay have [Jr-oblcrns trlat cannot t)C rC2ldHy fixcej such as a cJaiTI2)gccJ frarnc or 2 rusted. thrcuqh t;ody. /\ wlth a branded title (saJvdq f flOOcl) etc.) or t.irlsubsteli"'lliatecJ !Yd:(~aGc is ccnsidered !'poor H A veh cle in poor concHtion indcpc!'jclc'nt appi"aisdl to dcl.Cf'(nlne ts v,aluc, Kelley f3!ue report a value on vehicle t)ccau.sc the * Pennsylvania 3/8/2007 ~ Close Window Total Control Accoun( 'MetLife MetropolitaII Life 'InsuranceCompuny DONALD EBERSOLE 6916 WERTZVILLE RD APT 5 ENOLA PA 17025.1037 Date ~/~7 0096 62-15/311 2196 Pay, to the If] 7' 1 Order oL".J7/1/'e.. d/"tP/GrtJt<IYv te:1V~jtJlf.. cP:~....~'..-<7./~~".~ Check "01 va/idfor/esst/w" $250 .. .' .' " .... . PNCBank, Delaware 11$ ~17.r-OO I 0-0. . . ./,,0 . Dollars~Sefuri1rl:a'e:lllfes , ..... '-. -. - -- - - -.-.- - -LlJ r5~t~~ ~Jieback Memo .< C Ad/der- Signature ~~'.;c.~ 1:0 :l1.1.00 l. 571: ...05288 T7l. Sill OOgb Kelley Blue Book THE TRUSTED RESOURCE kbb.com atj \jerti~:;c ITlcnt 2000 Chevrolet Express Van 1500 Passenger BLUE BOOK; TRADE.IN VALUE advertisernellt Standard 8 Passenger Air Conditioning Power Steering AM/FM Stereo Dual Front Air Bags ABS (4-Wheel) Vehicle Details Mileage: Engine: Transmission: Drivetrain: 45,000 VB 5.0 Liter Automatic RWD Selected Vehicle Optional Rear Air Power Windows Power Door Locks Tilt Wheel Cruise Control Multi Compact Disc Leather Quad Seating Blue Book Trade-In Value Trade-in Value is what consumers can expect to receive from a dealer for a trade- in vehicle assuming an accurate appraisal of condition. This value will likely be less than the Private Party Value because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. Vehicle Condition Ratings !::.xceuent $6,450 that the vctlick: !clfJks ne\N1 lS in ceHent 110 rCCO!lcjitlol1ing,ti'liS vehicle h hac! dny paint Of !:; free of rust. The vch!(~!c; ha~) a clca title history dnd \:vili a dnd safetY' inspection, The enqinc cornpartnlent VViUl no leaks and I:; fref:'~ of Elny or visible (jefects. fhe Ih1S ccrnpictc: and r'ecorejs than of aH fa!! intCJ ../ Good (Selected) $5,970 "Good" condition means that the vehicle is free of any major defects, This vehicle has a clean title history, the paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. There should be little or no rust on this vehicle. The tires match and have substantial tread wear left, A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category, fair $5,170 "Fai(l condition n1Ci3ns tllat tile ve-hicle has ~;OlT)C niC'chanlcaf or cosnlc:tic dcft'::cts and needs servicing Lul lS stl!r in reasonable running condition, This vchjc:!e has a clean title history! the paint, t)ody and/or interior need v\!ork per'fonned by a prof(:ssiona!. The tires rnay nef:o to be replaced, 'There rnay be scrne. repairab~e rust d2lnldf.]C, Poor NIP-. npoorO condition rDeans that the vehicle has severe rnechanici3! and/or cnsnletJc defects ancj is in poor runnin~1 condition, The \lchick: rnay have probJerns that cannot be readiiy fixed such as a di3i1iaged franlf:: or a rust.ed- through L)ody, A vehicle v'nth a l)rdndcd title (solva~]e, floOG, etc.) or unsubsL::lnhatej is considered Hpoor.11 f\ vehicle in poor condition rCCUln:~ inc1epcndcllt Elpnr(jjSdl to dcterrnine its value, Kelley B!uc Hook docs not to report value on (3 lIpoo(' vehicle because the value of In thiS catc90ry \',:1(05 ~]reat!y. * Pennsylvania 3/8/2007 Sflt/;;~ .;) /~ ~/o 7 /O:/S-'~ ~. ~ !/~. .~ ~~~ ;7-/L---' :;5 to LIS-C. 0 D '/ .7cS ~. /. Dear Ms. Radcliff, Timeshare Market Value This market value was performed on January 29th, 2007. Per your request, we have prepared a complete timeshare market evaluation based upon the information you have provided. The purpose of this valuation is as follows: 1) To provide a professional, unbiased presentation that establishes a value for the requested timeshare; 2) To provide the timeshare owner and/or potential buyer/renter with a market value of the requested timeshare; and 3) To provide a unique valuation of the timeshare that will be of high value and interest to both the owner and any potential buyers/ renters. This historical information is provided by an internal collection of data. The values listed below include properties that were marked as sold/rented by individuals currently or previously advertised with our company. This includes only values from the secondary market and do not include sales or rentals directly from the resort. The values below are not opinions. The historical values provided are not to be used as a guarantee as to what your timeshare will sell and/or rent for. The timeshare may sell and/or rent for more or less than the comparables listed below. Item Resort Com Fairfield Kingsgate 1 bedroom 1 bathroom N/A > Week #38 Yes No N/A Within past US$2JOOO US 450 Bedrooms Bathrooms Annual Points Week # Owned Deeded Property Leased Property Lease Expires Transaction Sold Rented Average Resa Ie Value of Coni PliI..a P'l'lS Average Rental Value of Compari:lbles Please note that the values listed above are based on historical data and are not opinions of our staff or anyone associated with Vacation Timeshare Rentals, LLC. Our agency has no control over the sales and/or rental prices of the com parables listed above. This is factual data and not an appraisal nor an opinion. Vacation Timeshare & Rentals. LLC 1-800-417-1829 www>VacationTimeshareRentals.com APPRAISAL CM/!-U5-s P--d i 1160{"A fj fJ /!. Date 3 --5-13 ITEM VALUE Personal Property of ';;:-ST4TE w/LE-tFd ./::/3151<--5 iJLC Appraised by Chuck E. Bricker AU094-L ITEM VALUE c:2. 0 PO /0. OD L./O,Dv 2JJ I {)() ~,()O !J-; OJ) ;20 / (yD ;0 dlJ e2() I tl[) I(),() IS. 0 ~ --, () () / {; 0 , ao ,Db /0 Of) SO ( Ob ~;),OD J () ()() - - - - -= - - -= - Prudential ~ Financial !-:liJI.',27J8, C( 1>.\(' Page 1 of 3 Strategic Partners Select Annuity Statement January 01,2007 through March 31, 2007 Prudential Annuity Service Center POBox 7960 Philadelphia, PA 19176 >07068 3510913 004 092001 WILFORD D. EBERSOLE 4714-A CHARLES RD MECHANICSBURG, PA 17050 Annuity # Owner Name: Annuitant E0362738 WILFORD D. EBERSOLE WILFORD D. EBERSOLE Type IRA Investment Professional: SCOTT A MOYER PRUDENTIAL - PIF 150 CORPORATE CENTER DRIVE SUITE 105 CAMP HILL, PA 17011-1759 Issue Date: Statement Date: 03/22/2005 04/01/2007 For 24-hour access to your portfolio performance, investment options, current account values and other information: Sign on to our interactive Web site www.prudential.com Or call our Annuity Service Center at ] -888-778-2888. For other inquiries on your Annuity Contract, contact your Investment Professional at (7] 7) 975-8] 50. Please review your statement thoroughly and contact us if you find any information you believe to be inaccurate. If we do not hear from you In 30 days, we will assume that all information is correct. Your Portfolio Current Quarter Year-to-Date Since Issue $53,593.03 $53,593.03 .00 .00 .00 $47,552.66 .00 .00 ($800.00) .00 .00 .00 $57141 $57141 ct'7 L1 ' 1 '70 """,' 1..1..' v $54,164.44 $54,164A4 $54,164.H $52,262.34 Your Annuity Activity Beginning Value Purchase Payments Withdrawals Contract Fees and Charges Investment Performance Ending Value Surrender Value ------- _ i'i.\t'd I ~I\'.\ 1~(J11d Large Cap 1111'II.jluil\' :llid/SlTIall Cap ---<'.. ;\gl'llt I]) # ~C.131_)jJl (1C!i,"(-' # \\' Sfl D L<lrg" Cap Jl.1(}I~'(j D Ilid/Snwl1 Cap ]] 11)% Inti b:'1uity f).()J~j) _ BUild 1471% _ Fi:,,-r11 ~1\'I\ -+:l,C)UU;(\ Prudential ~ Financial The Prudential Insurance Company of America Pruco Life Insurance Company Pruco Life Insurance Company of New Jersey Annuitant: WILFORD D. EBERSOLE Annuity Contract No. E0362738 Subject to Terms and Conditions of section titled" Beneficiary", the following beneficiary(ies) are hereby designated: BENEFICIARY PROVISION The proceeds that arise from the Annuitant's death will be payable in one sum as follows: Class 1 15.00% CHRISTIAN LIFE ASSEMBLY, of CAMP HILL, P A. 35.00% CHAD W. EBERSOLE, Son 35.00% DONALD P. EBERSOLE, Son 5.00% DONNA DEA YEN, Friend 5.00% PATRICK K. EDERSOLE, Grandson 5.00% RUTH EDERSOLE, Friend Endorsed or Acknowledged for the Company by: cA.41~{ t.. )C~ Clifford E. Kirsch Secretary Date: 10/13/2006 Pruco Ufe Insurance Company and Pruco Life Insurance Company of New Jersey are both Prudential companies